Dissatisfaction with performance of valued activities predicts depression in age-related macular degeneration.

OBJECTIVE

To determine whether dissatisfaction with performance of valued activities predicts depression in patients with age-related macular degeneration (AMD).

PATIENTS

Two hundred and six patients with newly diagnosed neovascular AMD in one eye and pre-existing AMD in the fellow eye who were participating in a clinical trial of a psychosocial intervention to prevent depression.

MEASURES

Structured clinical evaluations of vision function, depression, visual acuity, contrast sensitivity and medical morbidity. Subjects were classified as dissatisfied if they indicated that they were dissatisfied with their performance of a valued activity.

RESULTS

Subjects who were dissatisfied with performance of valued activities (n = 71) had similar demographic characteristics to satisfied subjects (n = 135) but had worse visual acuity (p < 0.054), greater medical comorbidity (p < 0.006), and lower vision function (p < 0.001). Dissatisfied subjects were almost 2.5 times more likely (OR = 2.41; [95% CI 1.02, 5.65]; p = 0.044) to become depressed within 2 months than satisfied subjects independent of baseline visual acuity, vision function, and medical comorbidity.

CONCLUSION

Dissatisfaction with performance of valued activities in older persons with AMD predicts depression over a 2-month period. Assessing the ability to pursue valued activities may identify patients at risk for depression and prompt clinicians to initiate rehabilitative interventions and careful surveillance for depression.